Summary

On December 6, 2016, the US House of Representatives passed the Expanding Capacity for Health Outcomes Act (S. 2873) (the ECHO Act), which was unanimously passed by the US Senate on November 29, 2016. The ECHO Act seeks to expand the use of health care technology and programming to connect underserved communities and populations with critical health care services.

In Depth

As 2016 comes to a close, digital health continues to be a focal point on both the state and federal levels. On December 6, 2016, the US House of Representatives passed the Expanding Capacity for Health Outcomes Act (S. 2873) (the ECHO Act), which was unanimously passed by the US Senate on November 29, 2016. The ECHO Act seeks to expand the use of health care technology and programming to connect underserved communities and populations with critical health care services.

By way of background, the ECHO Act is a product of the University of New Mexico Health Sciences Center’s telehealth initiative named “Project ECHO,” a world-renowned program launched in 2011 to address access to Hepatitis C care. Project ECHO uses a “hub-and-spoke” model to connect health care specialists with rural providers and their patient populations using a telehealth platform (e.g., multi-point videoconferencing). Under the model, specialists at a “hub” hospital conduct virtual clinics and training for primary care providers at “spoke” sites, including many rural health systems. As a result, quality patient care is provided and managed locally—without the need for referrals or patient/physician travel. Since Project ECHO’s inception in 2011, the model has expanded—across diseases, specialties, urban and rural settings, and different types of payment models—and has been adopted by governmental agencies and in other countries.

The ECHO Act builds upon the University of New Mexico’s telehealth initiative by encouraging the broader development and use of technology-enabled collaborative learning and care delivery models by connecting specialists with multiple other health care professionals through simultaneous interactive videoconferencing for the purpose of facilitating case-based learning, disseminating best practices, and evaluating outcomes. A significant driver behind the ECHO Act is the need to address health professional shortages in rural areas and to provide support to rural providers who are struggling to meet patient demand. As background, only about 10 percent of physicians practice in rural areas of the United States—despite nearly one-fourth of the population living in these areas.

The ECHO Act requires the secretary of the US Department of Health and Human Services (HHS) to study technology-enabled collaborative learning and capacity building models, and the impact of those models on (1) certain health conditions (i.e., mental health and substance use disorders, chronic diseases, prenatal and maternal health, pediatric care, pain management, and palliative care); (2) health care workforce issues (e.g., specialty care shortages); and (3) public health programs. Within two years of the enactment of the ECHO Act, the secretary of HHS must submit a publically available report to Congress that:

Analyzes the impact of technology-enabled collaborative learning and capacity building models, including, but not limited to, the impact on health care provider retention, quality of care, access to care and barriers faced by health care providers

Lists the technology-enabled collaborative learning and capacity building models funded by HHS over the past five years

Describes best practices used in adopting these models

Describes barriers to adoption of these models, and recommends ways to reduce those barriers and opportunities to increase use of these models

Issues recommendations regarding the role of technology-enabled collaborative learning and capacity building models in continuing medical education and lifelong learning, including the role of academic medical centers, provider organizations and community providers in such education and lifelong learning

The recommendations made in HHS’s report may be used to integrate the Project ECHO model into health systems across the country.

Lisa Schmitz Mazur is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Chicago office. Lisa maintains a general health industry practice, focusing on the representation of hospitals and health systems and other health industry providers.

Shelby Buettner is an associate in the law firm of McDermott Will & Emery and is based in the Firm’s Chicago office. She focuses her practice on general health law matters.

Shelby previously coordinated clinical trials at an academic medical center, managed biomedical development projects with the Department of Defense and National Aeronautics and Space Administration, and conducted research with the United Nations Environmental Programme. She has been published in American Journal of Surgery, Journal of Robotic Surgery, Urologic Clinics of North America, Surgical Endoscopy, and Administrative Theory & Praxis.

Shelby received her J.D., cum laude, from Northwestern University School of Law in 2015. She completed a fellowship at Duke University and earned her M.P.A. and her B.S in political science, magna cum laude, both from University of Nebraska.

Marshall E. Jackson, Jr. is an associate in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Washington, D.C. office. Marshall focuses his practice on transactional and corporate matters affecting health care organizations, including business organization, corporate governance, mergers and acquisitions, strategic affiliations and joint ventures. Marshall also provides advice and counsel on a full range of federal and state fraud and abuse laws to hospital systems, medical practice groups and pharmacies.

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